Anxiety and Panic Attacks

The WORST. If you’ve ever experienced anxiety or a panic attack, you know exactly how frightening this can be. Or perhaps you’ve watched helplessly as someone you love experiences anxiety or a panic attack. 

My best estimate is that most of us deeply understand this experience. A quick internet search will show you how much we talk about anxiety! Identifying treatments for anxiety became the focus of most of my research because I saw how many people struggle with anxiety and panic attacks. 

Anxiety is a normal and helpful response in certain situations. 

For example, anxiety can help keep us alert to changing traffic conditions and help us perform as best we can on a test.

Panic attacks are different from normal anxiety. 

They serve no useful purpose and can happen out of the blue. Panic attacks can happen when the body senses that there is danger. This is known as the fight-or-flight instinct. 

Panic attacks usually last a few minutes, but can linger at a lower level of intensity for up to a few hours. A panic attack involves four of the following symptoms:

• Shortness of breath
• Dizziness
• Increased heart rate
• Sweating
• Choking sensation
• Nausea, stomach pain, or diarrhea
• Chest discomfort
• Tingling / numbness
• A fear of dying or losing control

The symptoms of panic attacks are often mistaken for heart attacks, heart disease, or another life-threatening illness. People experiencing panic attacks often make several visits to the emergency room and/or undergo multiple medical tests to rule out disease or illness. This is OK! You have a right to know whether you are struggling with anxiety, panic attacks or a physical health issue. 

Practice self-compassion as you figure out what you are experiencing, and surround yourself with a kind and caring team of health and mental health practitioners. 

If you are uncertain about whether you are experiencing a cardiac event or anxiety, please go to a hospital emergency room or see your doctor right away. Emergency room staff will always be happy to see you! 

If you are not having a cardiac event, it is time to do something about the anxiety. 

In Ontario, only a psychiatrist or psychologist can accurately diagnose anxiety disorder. Psychotherapy will support your journey to identifying root causes of anxiety, and strategies to cope with anxious reactions to situations. 

Anxiety disorders often co-exist with more severe problems, such as depression, alcohol or drug abuse, and even suicide attempts.

Anxiety is sometimes treated with medication.  In other situations, Cognitive Behavioural Therapy (CBT) or other psychotherapies is helpful.  CBT helps people to identify negative thoughts and perceptions that can lead to unhelpful styles of thinking.  

These strategies can help control the symptoms of a panic attack:

• Accept the symptoms and reframe your thoughts. You might say to yourself: ‘OK, here come the symptoms of panic again. I can accept this and let my body go through its reactions. I can handle this. I’ve done this before.’ 

• Don’t struggle with what your body is doing. Watch and observe your body’s reactions without reacting with more fear or anxiety. Mindfulness and meditation techniques can help you learn more about how to observe, accept and slow reactions.

• Allow the symptoms to pass on their own. Soothe yourself with statements such as:  ‘This will pass and I can ride it out’. Anxiety and panic attacks often follow the pattern of ocean or lake waves: the wave builds, crests, then recedes. Visualize ocean waves that build, crest and recede.  

• Think about what you were doing just before the panic attack. Keeping a record of your panic attacks can help you understand which situations lead to panic. 

• Work at changing your activities to reduce the chances of an attack. Some examples are reducing stress, increasing self-care, talking about your thoughts and feelings, practicing deep-breathing techniques, getting regular exercise, reducing or eliminating caffeine, and learning how to speak more positively to yourself.

• Recognize the early signs of a panic attack. Shortness of breath, increased heart rate, restlessness or agitation can all be signs of impending panic attack. When you become familiar with these symptoms, you can be prepared to respond to them without fear.

Other Helpful Strategies:

Practice abdominal breathing and taking slow, deep breaths.

Get physical with gentle activities such as stretching, yoga or walking. Lying down and/or vigorous activity can increase the intensity of the symptoms.

Talk to a supportive friend or relative who might be nearby or who you can call, not text.

Disrupt those thoughts by doing something you like to do, such as calling a friend, 

going to a funny website or crafting.

Ground yourself by touching the floor with your feet or hands, touching physical objects around you, or naming the objects you see around you. 

Hug someone you care for, or cuddle your pet.

Remember:  you cannot die from a panic attack.  The feelings will pass.